NPI | 1508158288 |
---|---|
Former Name | KALIE NICOLE BRENNEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CA 20A14112) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63056) |
Enumeration Date | 2011-05-12 |
Last Update Date | 2015-07-22 |